Cluster Map

December 14, 2010

In Treatment

During its first season on HBO, several of my patients mentioned watching, and enjoying, HBO's In Treatment, a show purporting to be an accurate depiction of the process of therapy and an introduction to the workings of the therapist's mind. The series started out more promising than I expected. There seemed to be an honest attempt to show how interpretations were made and how the skilled therapist could use the transference, the relationship between the therapist and the patient, for therapeutic change. Each night's half hour episode followed the progress of a particular patient through a period of time in their therapy. I was perfectly willing to accept the sensationalizing of therapy that was certain to occur in any theatrical depiction of therapy; like anything else that gets dramatized by Hollywood, most of the work in therapy takes place in non-dramatic increments which would be hard to watch on TV. Unfortunately, by the second half of the first season I found myself growing increasingly disenchanted. The therapist began to have more and more trouble maintaining therapeutic neutrality and the show began to go so far over the top in order to dramatize the sessions that its resemblance to a therapeutic process was increasingly tenuous. By the end of the first season I had stopped watching and though I did check in on one or two episodes in the second season, my curiosity was slaked and I had accepted that, like everything else Hollywood touches, In Treatment was no longer about its nominal subject but had become an instrument for the creators of the show to illustrate their fantasies about therapy and therapists.

[As an aside, Hollywood does marvelous things in their depictions of Psychiatrists and other therapists. We range from the rare Saintly creatures like Judd Hirsch in Ordinary People, to extremely fallible people with no ability to maintain appropriate therapeutic limits, like Barbra Streisand in The Prince of Tides, to the wonderfully malefic Michael Caine in Dressed to Kill and the brilliantly over the top pure evil of Anthony Hopkins in The Silence of the Lambs. In general, Psychiatrist as malevolent destroyer of innocents tend to out number Psychiatrist as noble Savior of psyches in popular culture. This says more about Hollywood and unconscious fantasies of Psychoanalysis than it does about the reality of therapy; it also tends to be much more entertaining than most psychotherapy sessions.]

First, In Treatment: the first two seasons were adapted from an Israeli series; the third season, completed last week, was not. In the last episode, Paul Weston, a clinical psychologist, doubts whether or not he should remain in his profession, for he has no objective way to evaluate the accuracy of what his clients are telling him. This is postmodernist uncertainty and existentialist despair, pure and simple. Whereas at least one of his patients in season one (the teen-age gymnast) was pulled back from the brink of suicide through therapy, in season three, Sunil, the Indian father-in-law of the blonde and assertive “Julia,” has tread lightly on the truth in order to get himself deported back to his home country, thus triggering a failure of nerve in Paul. We are left hanging in the season finale, as Paul, rejected as a sexual partner by his latest female therapist, melts into the Brooklyn street, a street inhabited by hoi polloi. Such a dim view of therapy can only bolster the anti-psychiatry movement that does not base its critique on something persuasive, such as the clinical emphasis on the immediate family as opposed to the family as it operates in an abundance of confusing and failed institutions (schools, the justice system, state-imposed bureaucratic rules that strangle production and innovation in general).

Psychoanalysis and Psychoanalysts spend a great deal of time and psychic energy trying to understand the difference between reality, psychic reality, and fantasy. There is tremendous overlap but the effect on one's psyche from real trauma remains much more indelible than the effects of fantasy, though the relationship between the two is complex and they are often inextricably intertwined. To succumb to "postmodernist uncertainty and existentialist despair" may be trendy but devalues the therapeutic work that therapist-patient combinations can accomplish and, as noted by Clare Spark, tends to empower the larger social structures over the individual.

Her comments about Boardwalk Empire (which I have never seen) are trenchant and worth considering in all of our discussions of how the moral structures that undergird our culture are under attack:

By comparison with agent Van Alden (an old Dutch-American name), Nucky and his chief lieutenant, a returning wounded veteran of the first world war, are model citizens, for they are home-loving and monogamous; the audience will side with these amiable Irishmen against their Italian and Jewish thug enemies. That is how stories work. Even if the protagonists are anti-heroes, their “good” sides and damaging family histories will encourage the audience to identify with them. (Recall the anxiety that many fans experienced at the ambiguous ending of The Sopranos.) The audience will root for them, just as they root for the lawless celebrities and political leaders who are standing up for “law and order” in today’s endlessly cynical political culture of today—a culture that condemns the Puritans as narcissists and killjoys, while elevating the pornography of sex and violence as some kind of artistic breakthrough in mass entertainment.

Those who make their living (a very good living) by supplying entertainment, the visual and aural images which form the basis of our modern mythology, claim that they are only giving their audiences what they want. It is true that few go broke pandering to the most base impulses of our natures, but a culture that replaces love and respect with the "pornography of sex and violence" is a culture that is voraciously embracing decadence (an admittedly archaic term in a post-modern culture) that, among other things, presages the fall.

The lower socioeconomic classes have been committing cultural suicide for a very long time; now the middle of America is moving down the same path:

Comments

In Treatment

During its first season on HBO, several of my patients mentioned watching, and enjoying, HBO's In Treatment, a show purporting to be an accurate depiction of the process of therapy and an introduction to the workings of the therapist's mind. The series started out more promising than I expected. There seemed to be an honest attempt to show how interpretations were made and how the skilled therapist could use the transference, the relationship between the therapist and the patient, for therapeutic change. Each night's half hour episode followed the progress of a particular patient through a period of time in their therapy. I was perfectly willing to accept the sensationalizing of therapy that was certain to occur in any theatrical depiction of therapy; like anything else that gets dramatized by Hollywood, most of the work in therapy takes place in non-dramatic increments which would be hard to watch on TV. Unfortunately, by the second half of the first season I found myself growing increasingly disenchanted. The therapist began to have more and more trouble maintaining therapeutic neutrality and the show began to go so far over the top in order to dramatize the sessions that its resemblance to a therapeutic process was increasingly tenuous. By the end of the first season I had stopped watching and though I did check in on one or two episodes in the second season, my curiosity was slaked and I had accepted that, like everything else Hollywood touches, In Treatment was no longer about its nominal subject but had become an instrument for the creators of the show to illustrate their fantasies about therapy and therapists.

[As an aside, Hollywood does marvelous things in their depictions of Psychiatrists and other therapists. We range from the rare Saintly creatures like Judd Hirsch in Ordinary People, to extremely fallible people with no ability to maintain appropriate therapeutic limits, like Barbra Streisand in The Prince of Tides, to the wonderfully malefic Michael Caine in Dressed to Kill and the brilliantly over the top pure evil of Anthony Hopkins in The Silence of the Lambs. In general, Psychiatrist as malevolent destroyer of innocents tend to out number Psychiatrist as noble Savior of psyches in popular culture. This says more about Hollywood and unconscious fantasies of Psychoanalysis than it does about the reality of therapy; it also tends to be much more entertaining than most psychotherapy sessions.]

First, In Treatment: the first two seasons were adapted from an Israeli series; the third season, completed last week, was not. In the last episode, Paul Weston, a clinical psychologist, doubts whether or not he should remain in his profession, for he has no objective way to evaluate the accuracy of what his clients are telling him. This is postmodernist uncertainty and existentialist despair, pure and simple. Whereas at least one of his patients in season one (the teen-age gymnast) was pulled back from the brink of suicide through therapy, in season three, Sunil, the Indian father-in-law of the blonde and assertive “Julia,” has tread lightly on the truth in order to get himself deported back to his home country, thus triggering a failure of nerve in Paul. We are left hanging in the season finale, as Paul, rejected as a sexual partner by his latest female therapist, melts into the Brooklyn street, a street inhabited by hoi polloi. Such a dim view of therapy can only bolster the anti-psychiatry movement that does not base its critique on something persuasive, such as the clinical emphasis on the immediate family as opposed to the family as it operates in an abundance of confusing and failed institutions (schools, the justice system, state-imposed bureaucratic rules that strangle production and innovation in general).

Psychoanalysis and Psychoanalysts spend a great deal of time and psychic energy trying to understand the difference between reality, psychic reality, and fantasy. There is tremendous overlap but the effect on one's psyche from real trauma remains much more indelible than the effects of fantasy, though the relationship between the two is complex and they are often inextricably intertwined. To succumb to "postmodernist uncertainty and existentialist despair" may be trendy but devalues the therapeutic work that therapist-patient combinations can accomplish and, as noted by Clare Spark, tends to empower the larger social structures over the individual.

Her comments about Boardwalk Empire (which I have never seen) are trenchant and worth considering in all of our discussions of how the moral structures that undergird our culture are under attack:

By comparison with agent Van Alden (an old Dutch-American name), Nucky and his chief lieutenant, a returning wounded veteran of the first world war, are model citizens, for they are home-loving and monogamous; the audience will side with these amiable Irishmen against their Italian and Jewish thug enemies. That is how stories work. Even if the protagonists are anti-heroes, their “good” sides and damaging family histories will encourage the audience to identify with them. (Recall the anxiety that many fans experienced at the ambiguous ending of The Sopranos.) The audience will root for them, just as they root for the lawless celebrities and political leaders who are standing up for “law and order” in today’s endlessly cynical political culture of today—a culture that condemns the Puritans as narcissists and killjoys, while elevating the pornography of sex and violence as some kind of artistic breakthrough in mass entertainment.

Those who make their living (a very good living) by supplying entertainment, the visual and aural images which form the basis of our modern mythology, claim that they are only giving their audiences what they want. It is true that few go broke pandering to the most base impulses of our natures, but a culture that replaces love and respect with the "pornography of sex and violence" is a culture that is voraciously embracing decadence (an admittedly archaic term in a post-modern culture) that, among other things, presages the fall.

The lower socioeconomic classes have been committing cultural suicide for a very long time; now the middle of America is moving down the same path: